Fixing Concussions in Kids – 6 essential treatment components!
Did you know that approximately 46,000 Canadian children aged 5 to 19 had a concussion from 2016-2017? And this number is likely under-reported. Despite how common this problem is, many can find it difficult to find effective treatment.
You’ve probably heard a lot about concussions in kids from the media, but what is fact and what is fiction?
Treating Concussions in Kids with Physiotherapy
Recently, I had a patient come to the clinic presenting with a concussion after playing soccer with his brother. He wasn’t looking and took the ball right in the face!
Right away he was feeling nauseous and had a headache. And school from home on the computer screen was unbearable, but he was trying to be tough and power through so that he wouldn’t fall behind!
The first thing we went over was what exactly a concussion was, and how we were going to tackle the symptoms. And after some manual therapy, appropriate exercise prescription, and a return to learn program, he was back to school and backyard soccer in no time!
Concussions can be scary and uncertain, but they don’t have to be! We are going to cut straight through all the noise to provide you with the best facts for treating concussion symptoms in kids.
Symptoms of Concussions in Kids
In a concussion, the brain shifts inside of the skull. You don’t even have to hit your head for a concussion to occur. You can even get a concussion from jarring to the body without any head impact.
Some research indicates that suffering repeat concussions might increase the risk of other concussion related problems. But this is actually not true! Repeated concussions come from either repeated participation in risky sport activity, or incomplete treatment of the initial concussion. Even if the symptoms appear to have resolved on their own, physiotherapists can find lingering symptoms provoked by specialized tests!
Signs and symptoms of a concussion may include:
- Headache or a feeling of pressure in the head
- Nausea or vomiting
- Balance problems or dizziness
- Sensitivity to noise or light
- Difficulty concentrating and remembering information
- Feeling not like themselves
In children, you may also see more behavioural symptoms such as irritability, sadness, and emotional dysregulation.
It is important that your child receives complete treatment encompassing all the components listed below, regardless if you child is experience one symptom, or many!
Essential treatment components for concussions in kids!
Relative Rest
Immediate removal from activity, and appropriately timed rest, will lead to a quicker recovery and less intense symptoms. For these reasons, the first line of treatment following a concussion after immediate medical attention is REST.
You may have heard that this means the child should lay in a dark room and do nothing. But that is no longer the recommendation! We now recommend relative rest! This means your child can do anything that does not increase their symptoms.
So if they are okay reading book, going for walks, playing with lego…. Let them do as much of that as they would like!
But, nothing that increases their symptoms, and nothing that is very physically active! Also, it is important for you to keep your kids away from any activity that may result in another hit to the head!
One VERY important point about physical rest – it should not exceed 3-4 days! After that, gradual return to normal activity should begin as soon as possible.
Return to Learn Plan
You might be asking – What about school? As mentioned before, if doing some school work in the initial days after the concussion does not increase symptoms, then they are okay to continue school!
But, many children struggle with the mental demand of school. School often involves computer screens, making learning even more challenging!
Successful return to learning is important, and is a big piece of the physiotherapy treatment plan! Therefore it is important that your physiotherapist creates an individualized plan based on the unique class schedule of your child. This will include reduced hours, limitations on gym, screens, and noise levels, strategic rest breaks, and other important components!
Just pushing through it NOT the pathway to success! A plan that is progressed based on the success of the previous stage is necessary for successful return to school!
Unsure what kind of information to provide your child’s teacher? Check out this Academic Accommodations form!
Gentle Exercise
Exercise is medicine! I am sure you have heard that statement before… and it is true for concussion too!
While blood flow issues in the brain may be a component of your child’s symptoms, exercise is still recommended…. When well tolerated of course!
Physiotherapists typically start by recommending a gentle 30 minute walk a day. Start with a slow pace, and no external distractions. This includes busy parks or streets, loud noised or listening to music, and even really bright sunny conditions!
Part of physiotherapy treatment for your child’s concussion will include an assessment of their physical activity capabilities! Once your child is cleared for exercise, the physiotherapist will create an individualized return to activity and sport plan for your child. This is important to ensure a safe return to play!
Manual Therapy
Did you know that when you get a concussion, it is almost guaranteed you have also sustained a whiplash? If enough force went through your head to cause a concussion, there was enough force on your neck to cause damage to the soft tissue there!
And this is a common source of many concussion symptoms!!
Nausea, lack of balance, headaches, dizziness, and many more symptoms can all come from the neck! Therefore, it’s important that your child has a physiotherapist assess their neck to treat this source of symptoms!
Treatment often includes soft tissue techniques and manual therapy to treat both the muscles and joints. And don’t forget some physiotherapy exercises! Your child will also be prescribed neck strengthening and stretching exercises to help improve their symptoms.
Vestibular Treatment
What is vestibular treatment? Vestibular treatment is performed by a certified Vestibular therapist. It involves specific exercise-based techniques to treat issues in your vision and balance systems!
Because the neck is so tightly integrated with our vision and balance systems, any trauma to the neck (as mentioned above) can result in changes to those systems too.
Your child can have underlying issue lingering in these systems. Maybe it is obvious dizziness or motion sickness in the car, or maybe it is less obvious, like symptom provocation from prolonged visual focusing. Regardless, a specialized assessment can help us see if vision and balance integration may be contributing to your child’s symptoms!
Prevention and Recognition
Helmets, special mouth guards, and headbands actually do nothing to help prevent a concussion.
You read that right! There’s no way to keep the brain from moving inside the skull. Unfortunately, if you hit your head hard enough, your brain can shift in your skull and result in a concussion.
So why do you wear a helmet? Helmets prevent injuries like skull fractures, bruising, and facial injuries, etc. You’re probably thinking, if helmets don’t prevent concussions, then what does?
- Strengthening your neck muscles will help. Strong neck muscles may be able to help absorb some of the impact of blows to the head and decrease the risk of concussion.
- Always wear seatbelts in the car and buckle children in safety seats.
- Install safety guards by windows and stairwells to keep children from falling out.
- Strategic sport related training! Learning the right way to tackle, go into contact, and perform your sport is an important way to prevent concussions.
- Education! Having discussions with your kids about concussions, these preventative techniques, and early recognition!
Getting Treatment for Concussions in Kids
Concussions in kids can be frightening and worrying, but by following clinical recommendations most concussions in kids will recover without any lasting problems. And luckily, you are now armed with the information to make informed decisions and help your child recover!
Call us at 437-747-6236 to book an appointment with our certified vestibular physiotherapist!
FAQs
What should I do after a concussion?
Rest. Immediate removal from activity and appropriately timed rest are both directly linked to quicker recovery and less intense symptoms as a result of a concussion in children. For these reasons, the first line of treatment following a concussion after immediate medical attention is REST.
How do I know if I have a concussion?
A diagnosis of a concussion will be used when you have at least one associated concussion symptom following an impact to the head, or to the body resulting in acceleration of the head and neck. To confirm the diagnosis, and ensure there is nothing more serious going on, it is important to see a certified health professional to confirm the diagnosis.
What happens if a concussion goes untreated?
While many concussion symptoms will resolve on their own, it is important to get an assessment from a qualified professional to rule out any associated condition. If you have a diagnosis of a concussion, enough trauma has gone through your neck to be diagnosed with a whiplash. This means that the neck, vision, and balance systems may also be compromised. It is important to rule out damage to these systems to prevent life-long complications.